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RCGP legal fees could hit £100k over exam row

Exclusive The RCGP could spend up to £100k fighting a judicial review into the fairness of the MRCGP exam for international medical graduates, Pulse can reveal.

A letter sent by the college’s solicitors to the British Association of Physicians of Indian Origin - dated 21 August and obtained by Pulse - reveals that the RCGP has already spent £42,000 fighting the legal action over the MRCGP.

It also reveals that the college estimates the overall cost of fighting the judicial review could total £97,000.

BAPIO has been granted a judicial review on the differential pass rates for IMGs and UK graduates taking the MRCGP after talks between the college and international doctors’ groups broke down earlier this year.

Court documents reveal that BAPIO is claiming that the assessment is directly discriminatory and should be declared unlawful. But a recent leaked draft copy of the GMC-commissioned review into the MRCGP exam concluded ‘significant differences’ in failure rates between different ethnic groups in the clinical skills examination are unlikely to be the result of bias.

In the letter, the RCGP’s solicitors Clyde and Co confirm that the costs for the college are likely to nudge six figures.

It says: ‘As you will be aware, our client has already incurred significant costs in relation to this claim and its legal fees to date have exceeded £45,000. We estimate that our client will incur an additional £52,000 in legal fees in preparing and submitting the detailed grounds for contesting the claim.’

The letter also demands that BAPIO provides the potential costs that it would have to pay if the judicial review goes against it and places it into a bank account as ‘security’ for the college.

No date has been set for the judicial review, though there is to be a hearing in October to decide whether the GMC has charges to answer.

An RCGP spokesperson said: ‘We take equality and diversity issues very seriously and strongly refute any allegations that the MRCGP exam is discriminatory. We are incurring legal costs in relation to this matter but our members should be reassured that, as a charity, we are only doing so to the extent appropriate and are keeping them under review.’

Dr Ramesh Mehta, president of BAPIO, said: ‘We believe the application for costs in advance is extremely unfair and we will in no way be paying the costs in advance.’

Readers' comments (12)

  • The RCGP is trying to stifle justice by intimidating BAPIO. When will they learn? Humility and culture change required.

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  • I think if the BAPIO they will expect to claim costs from the royal college. If the Royal College wins they can expect the same in return.

    Both parties (not just the BAPOI) should deposit the same amount into a secure account and the court can decide costs at the end of the case.

    Surely nobody can argue that is unfair?

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  • £1563 x 4 per an IMG and BME candidate and they want more? I am infuriated.

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  • Well done college. Squeeze out as much as you can (Greed is good). Nothing wrong with that.

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  • I love the way there are so many complaints about the cost of membership and the cost of exams.

    Then when the college tries to defend it's finances, so that these need not increase further..... the same people complain.

    Sounds like some people just like complaining.

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  • The BAPIO should use their resources to help with the education of their membership and their colleagues so they can reach the required standard, rather than fighting the RCGP so that the standards will be lowered to meet those of the BAPIO membership.

    I am of Indian origin and had no problems with any part of the assessment. But compared to those who did, my communication when starting GP training was better and I worked harder during my training. There are some in the group who need extra support than others. They should be funding this themselves or accessing funding through support groups such as the BAPIO. They should not expect things to be spoon fed to them and they should not expect special measures to be put into place so that they can be accommodated.

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  • @918am ; Are you of Indian origin or Indian IMG? . Lets not forget the psychological impact on morale of IMG trainees by this whole SAGA and failure rate.
    If there is no problem with CSA exam , surely there selection criteria is to blame. why employ people who almost certainly to fail ? is it just to balance books.

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  • I am of Pakistani origin. Generally Indians have better fluency in English but some Indian States have a vernacular that can be incomprehensible. Language goes with culture and effective communication is more important in general practice. Whilst IELTS tests spoken skills it can be easily mastered. The CSA is fair and an accurate reflection of this country as a whole. To state certain IMGs will never leave inner city Brum or Bradford is wrong. A GP must be able to practice anywhere. I feel the issue isn't linguistic but cultural. Most foreign doctors can not appreciate cultural norms here and often insulated in unintegrated circles compounds the problem. BAPIO should learn from the evidence and spend their resources on addressing the problems these IMGs face. It isn't malice which causes patients to complain when they find they aren't understood or can't understand the doctor.

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  • @7.38pm
    I am Indian origin, not IMG. I understand that the figures for IMG are worse than those of British graduates of Indian origin.

    To say they are allowing people in who have no chance of success is perhaps unfair. If there were a candidate who could make it but only if they work extremely hard (and there are not better candidates) it is appropriate to afford that candidate the opportunity. If they fail it perhaps means that they have not worked hard enough or perhaps the selection centre cannot get it 100% right...... but that is the case for any test.

    I think that it is better that some candidates who are 'borderline/cannot make it' are given the opportunity to train, rather than some candidates who are 'borderline/ can make it' are excluded. You certainly cannot organise an affordable selection centre test which distinguishes between the two 100% of the time.

    It is a bit like a screening test, everyone who passes should be afforded the opportunity to have training/ take the diagnostic test, but some will ultimately not make it. It perhaps should be a credit to the RCGP that they are willing to invest training funds in borderline cases; or may just represent that there are not enough candidates for the posts.

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  • I don't think the RCGP has set out to discriminate against IMG's but it has unintentionally. The consequences amount to the same thing of course.

    Could it be that the goal posts were moved in an attempt to improve standards? It is likely that many of those failing the CSA now would not pass the current selection test:

    http://gprecruitment.hee.nhs.uk/reports/ED_SUMMARY_2009_TO_2012.xlsx

    (Look at the med schools row 'overseas' - see how success from invitation to selection centre to being offered a place has plummeted from about half to only a third).

    Are trainees simply trapped in a system that has changed? (assuming the CSA (exit) exam has changed in the same way). That would surely be a contractual issue too. The remedy would be to assess these trainees in the same way that they would have been at the time they entered training. It makes no sense that they have competently and safely dealt with thousands of patients but that the exam tests something for which they were never selected in the first place. They are only the same as GPs currently practising and who went through a different exam.

    It would be better use of RCGP funds to simply arrange another exit route in order to qualify these doctors and compensate them their fees, loss of earnings and distress and allow them to get on with their lives and to do the job for which they are already trained.

    They also need to address the issue facing any who fail at the end or drop out for other reasons - that, unlike other specialties there are no other options. The country wastes vast amounts in training doctors yet many are stuck outside the system, unable to work.

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